Individual
MR. TRAVIS JAMES BRUECKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 LAWLESS ST NE, KEIZER, OR 97303-4667
(503) 507-7274
Mailing address
921 LAWLESS ST NE, KEIZER, OR 97303-4667
(503) 507-7274
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC186260
OR
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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